Timing of Excessive Pregnancy-Related Weight Gain and Offspring Adiposity at Birth

Davenport, Margie H. PhD; Ruchat, Stephanie-May PhD; Giroux, Isabelle RD, PhD; Sopper, Maggie M. PhD; Mottola, Michelle F. PhD, FACSM

doi: 10.1097/AOG.0b013e31829a3b86
Original Research

OBJECTIVE: To evaluate whether the timing of excessive maternal weight gain in a cohort of women following current guidelines for healthy living during pregnancy affects neonatal adiposity at birth.

METHODS: One hundred seventy-two healthy women who were at least 18 years old with body mass indexes (BMIs) of at least 18.5 were recruited between 16 weeks and 20 weeks of gestation. The cohort followed healthy living guidelines during pregnancy and were retrospectively grouped according to 2009 Institute of Medicine guidelines for weight gain in the first and second halves of pregnancy: 1) appropriate gestational weight gain (ie, within Institute of Medicine recommendations) in the first and second halves of pregnancy (“overall appropriate”); 2) appropriate gestational weight gain in the first half of pregnancy and excessive gestational weight gain in the second half of pregnancy (“late excessive”); 3) excessive gestational weight gain in the first half of pregnancy and appropriate gestational weight gain in the second half of pregnancy (“early excessive”); and 4) excessive gestational weight gain throughout pregnancy (“overall excessive”). Primary measures included neonatal weight, length, BMI, and body fat at birth measured 6–18 hours after delivery. Neonatal body fat greater than 14% was considered excessive.

RESULTS: Neonates of women who gained excessively in the first half of pregnancy exhibited greater heel-crown length, birth weight, and excessive body fat (“early excessive” 17.5±3.1%, “overall excessive” 18.7±3.3%) compared with those born to women who gained appropriately (“overall appropriate” 13.2±4.1%; “late excessive” 14.7±3.3%; P<.01). Neonates of women who gained excessively in the first half of pregnancy had an increased risk (odds ratio [OR] 2.64, 95% confidence interval [CI] 1.35–5.17) of elevated body fat at birth compared with neonates of women with total excessive weight gain (OR 1.49, 95% CI 0.80–2.79).

CONCLUSION: Timing of excessive weight gain is an important factor influencing neonatal morphometrics. Prevention of early excessive weight gain should be encouraged in the period before conception and reinforced early in pregnancy.

LEVEL OF EVIDENCE: II

Timing of excessive gestational weight gain is an important factor influencing adiposity at birth.

Physical Activity and Diabetes Laboratory, Faculty of Physical Education and Recreation, the Women and Children's Health Research Institute, and the Alberta Diabetes Institute, University of Alberta, Edmonton, Alberta, Canada; the R. Samuel McLaughlin Foundation–Exercise & Pregnancy Laboratory, School of Kinesiology, Faculty of Health Sciences, the Department of Anatomy and Cell Biology, Schulich School of Medicine, and the Children's Health Research Institute, Western University, London, Ontario, Canada; and the Nutrition Program, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.

Corresponding author: Margie H. Davenport, PhD, Physical Activity and Diabetes Laboratory, 1-059D Li Ka Shing Centre for Health Research Innovation, University of Alberta, Edmonton, Alberta, Canada T6G 2E1; e-mail: margie.davenport@ualberta.ca.

Financial Disclosure The authors did not report any potential conflicts of interest.

Funded by the Canadian Institutes of Health Research (CIHR). Dr. Davenport was supported by the CIHR Doctoral Research Award and the Heart and Stroke Foundation/CIHR Focus on Stroke Fellowship. Dr. Ruchat was supported by a Canadian Diabetes Association Fellowship.

The authors thank Dr. Craig Steinback for critical review of the manuscript.

© 2013 by The American College of Obstetricians and Gynecologists.